HomeMy WebLinkAbout2232 Lager St - Applications/Reroof - 12/20/2018Dec 2018 01:33p Severe Weather Roofing
9702233383 PA
r F&Citvof Planning, Development, $ Transportation Services
t C6thnS: Community Development & Neighborhood Services
' 281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 970.224.6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement �PRoofing ❑ Sewer Line C Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # 01 )qWc) Date )2;&6 /8
For office use only
Sob Site Address (required) Value of Construction (labor, materials, profit)
z32 10-9 c s o� Cdl, a 19',o0.�
Property Owner Name Address City/State Zip Phone
q 70-5-467 218,9
Applicant Name U Address City/State Zip Phone
Contractor Address City/State Zip Phone
7-7-32- v q7& -S4y 17r8
Contractor City of Ft. Collins Safes Tax # U Are you paying taxes here or by report? ❑ Here ❑ Report
sWestax mumberisrepulredbyall rontracfa . Are you paying with your trust account? ❑ Yes ❑ No
7s-1
Is this a residential or mmercial project? Residential Q Commercial
If residential, Is it: ?Single Family Detached ❑ Cando/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes O Nc Ifyes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work iq
ma
i
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electridan.
Subcontractors: List the company nameorCity cfictCollfnslicense.#
Electrician Plumber Mechanical Roofer4g�L,",gr Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:
L
Print Name: Signature Date 6
Revlon dale ZA=T